What is Smallpox Vaccine?

Smallpox infections are caused by a variola major virus, and the symptoms include sore throat, headache, vomiting, and fever, among others. In a few days, raised rashes will be visible on the face and body, and in the third week, scabs will occur and get detached from the skin. The smallpox vaccine can protect people from smallpox. It is made from vaccinia, a less harmful virus that is similar to the smallpox virus. When the smallpox vaccine is administered, it helps the bodies develop immunity to smallpox. 

Why is Smallpox Vaccine given?

About 30 percent of smallpox cases from variola major virus resulted in death, mostly in the 2nd week of infection. Most smallpox survivors had undergone permanent deformities of the nose, lips, ear tissue, and blindness that occurred because of scarring in the cornea.

Estimates suggest that the 20th century worldwide deaths caused due to smallpox stood at more than 300 million. Given such high fatalities caused due to the smallpox virus, smallpox inoculation has been the way forward to prevent the smallpox disease.

How does the Smallpox vaccine work?

  • Immune Response with antibody production

Smallpox vaccine is made from a live ‘vaccinia’ virus- a ‘pox’ type virus related to smallpox that induces milder diseaseThe smallpox vaccine triggers off an immune response in the human body by producing antibodies and cells in the blood and other parts of the body to help it fight against a real smallpox infection whenever it occurs

How is Smallpox Vaccine given?

  • Process of Puncturation with two-pronged, split hypodermic needles

Unlike most regular vaccines, the smallpox vaccine is not administered as a shot through a hypodermic needle. The smallpox vaccine is administered using a two-pronged, split needle that is immersed into the vaccine solution and the needle retains the vaccine droplets when removed from the solution.

The needle is then used to puncture the upper arm skin superficially about 15 times in a few secondsUpon a successful vaccination, the site of inoculation develops a red, itchy bump in 3-4 days

Who Should Get the Smallpox Vaccine?

With the eradication of smallpox cases from the face of the earth, there are very specific categories of population who could be administered the vaccine for emergency use. Listed below are such categories:

  • Not applicable to General Public

In 1980, the World Health Organisation (WHO) declared that smallpox disease has been eliminated from the surface of the earth. As smallpox no longer occurs in the world, the smallpox vaccine is not administered to the public anymore. However, in case of any smallpox outbreak, the smallpox vaccine must be administered to the public as per the guidelines of public health officials

  • Lab Workers and Military Personnel

Lab workers who work with the virus that causes smallpox or other similar viruses must get a smallpox jab. Some military personnel too, are inoculated as smallpox is considered as a potential biochemical weapon to be used in terrorist attacks

Who Should Not Get the Smallpox Vaccine?

Certain exempted categories of people as mentioned below were not allowed for routine immunisation of smallpox vaccine:

  • Senior Citizens and Children

Children aged below 18 years and old people aged above 65 years, in general, must not be administered the smallpox vaccine for non-emergency use. They can only be given this vaccine during emergency use

  • Persons with Weak Immunity

Persons with a weakened immune system such as those suffering from HIV, cancer and are on immunosuppressant drugs should not be administered the smallpox vaccine

  • Persons with Allergies or Severe Medical Complications

Individuals with skin conditions such as eczema, dermatitis, or psoriasis are also at increased risk of complications due to smallpox vaccine inoculation, and hence must be avoided

What Happens if I Miss a Dose?

  • Smallpox vaccine is normally administered as a single dose and administering it to the public is no more available, there should be no cause to be concerned about a missed smallpox vaccine inoculation dose

What are Smallpox Vaccine Ingredients?

ACAM2000 is the most popular smallpox vaccine that contains a live vaccinia virus derived from plaque purification cloning and grown in African Monkey kidney (Vero) cells. Here is a table of Smallpox vaccine ACAM 200’ ingredients:

Inactive Ingredients


HEPES (6-8 mM),

2 percent Serum Abumin USP,

0.5-0.7 percent Sodium Chloride USP,

5 percent Mannitol USP,

Traces of Antibiotics, Neomycin and Polymyxin B

50 percent Glycerin USP,

0.25 percent Phenol USP in water for injection USP

Smallpox Vaccine Pros and Cons


1. Pros


  • Boosts Immunity

People develop immunity quickly within a few days of smallpox vaccine inoculation and are sufficiently protected against the smallpox virus


2. Cons


  • Life-threatening Complications in rare cases

15 per 1 million people vaccinated develop life-threatening complications, with one or two people out of a million even dying from the vaccine

Smallpox Vaccine Side Effects

  • Mild and Common Side Effects

Common side effects of the smallpox vaccine include fever, headache, fatigue, mild body rash, itching, sore arm, and swollen lymph nodes

  • Serious side effects

These include swelling of the brain or spinal cord, vaccination site blisters, accidental eye infection causing painful or blurred vision, and any severe allergic reaction

  • Critical Side Effects

It may also cause severe heart problems, including myocarditis and pericarditis within 3-4 weeks of administering the vaccine


The discovery of the smallpox vaccine was an unprecedented scientific breakthrough in the field of medical research that pioneered a whole set of vaccines available across the world today. As per the WHO data, vaccination averts 2 to 3 million deaths per year, and upto 29 percent of child deaths under the age of 5 years are preventable with proper vaccination. This underlines the importance of prevention. And, the classic example of prevention is getting yourself secured with a health insurance plan.



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